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KMID : 1177320210240010036
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Korean Journal of Schizophrenia Research
2021 Volume.24 No. 1 p.36 ~ p.43
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Change of Prescribing Pattern after Clozapine Discontinuation: A Retrospective Chart Review
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Kang Shi-Hyun
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Abstract
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Objectives: Despite the high discontinuation rate of clozapine in refractory schizophrenia, there is limited evidence regarding the suggested treatment after clozapine discontinuation.
Methods: The medical records of 37 patients who discontinued clozapine were retrospectively reviewed. The prescription patterns of antipsychotics, mood stabilizers, and antidepressants were compared at three points before and after clozapine treatment and at the most recent visit.
Results: After clozapine discontinuation, 75.6% of the subjects were receiving antipsychotic polypharmacy, and 32.4% were taking more than 3 antipsychotics. The frequently used antipsychotics were olanzapine (21.5%), quetiapine (21.5%), and paliperidone (12.7%). The rates of augmentation with mood stabilizers and antidepressants were 43.2% and 29.7%, respectively. Furthermore, valproate was the most commonly used mood stabilizer (87.5%).
Conclusion: Antipsychotic polypharmacy and augmentation are inevitable in schizophrenia patients for whom clozapine has been discontinued. Further research is required to improve the outcomes of polypharmacy and augmentation in schizophrenia patients.
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KEYWORD
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Augmentation, Clozapine, Discontinuation, Polypharmacy, Prescribing pattern, Schizophrenia
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